Lower Respiratory Problems | Chapter 30 - Lewis’s Medical-Surgical Nursing (12th Edition) скачать в хорошем качестве

Lower Respiratory Problems | Chapter 30 - Lewis’s Medical-Surgical Nursing (12th Edition)

Chapter 30 of Lewis’s Medical-Surgical Nursing (12th Edition) covers a wide range of lower respiratory problems, focusing on their pathophysiology, clinical manifestations, complications, and interprofessional nursing management. The chapter begins with infectious conditions: ✨ Acute bronchitis – inflammation of bronchi often due to viral infections, presenting with cough, sputum, wheezing; managed with fluids, rest, bronchodilators, and cough suppressants. ✨ Pertussis (whooping cough) – highly contagious infection caused by Bordetella pertussis, producing violent coughing fits; treated with macrolide antibiotics. ✨ Pneumonia – classified as community-acquired (CAP), hospital-acquired (HAP), aspiration, necrotizing, or opportunistic. Risk factors include age, chronic disease, immunosuppression, smoking, and immobility. Clinical features include fever, chills, dyspnea, cough, sputum production, pleuritic chest pain, and crackles. Complications include pleural effusion, sepsis, lung abscess, and respiratory failure. Diagnosis uses chest x-ray, sputum cultures, and labs. Interventions include antibiotics, oxygen, fluids, antipyretics, analgesics, chest physiotherapy, incentive spirometry, and vaccines (pneumococcal, influenza). ✨ Tuberculosis (TB) – caused by Mycobacterium tuberculosis, spread by airborne droplets, primarily affecting the lungs but also extrapulmonary organs. Clinical features include cough greater than 3 weeks, hemoptysis, night sweats, fever, and weight loss. Screening includes TST (Mantoux), IGRA (Quantiferon), chest x-ray, and sputum AFB. Treated with long-term combination therapy (isoniazid, rifampin, ethambutol, pyrazinamide) under DOT (directly observed therapy). ✨ Atypical mycobacteria & fungal infections – opportunistic infections common in immunocompromised patients (HIV, transplant, cancer). ✨ Lung abscess – necrosis of lung tissue due to aspiration, producing foul sputum; treated with antibiotics and drainage. Restrictive problems include: 🫁 Atelectasis – alveolar collapse from obstruction or hypoventilation. 💨 Pleurisy – inflamed pleura causing sharp pain with inspiration. 💧 Pleural effusion – fluid accumulation in pleural space, managed with thoracentesis or chest tube. 🌿 Interstitial lung diseases – idiopathic pulmonary fibrosis (chronic, progressive scarring with poor prognosis) and sarcoidosis (granulomatous disease affecting lungs and other organs). Traumatic chest injuries include fractured ribs, flail chest, and pneumothorax (spontaneous, iatrogenic, tension), hemothorax, and chylothorax. Emergency management prioritizes airway, oxygen, IV access, chest tube insertion, and stabilization. Vascular problems include: ⚠️ Pulmonary embolism (PE) – caused by thrombi, fat, or air emboli obstructing pulmonary arteries. Symptoms include dyspnea, chest pain, tachypnea, tachycardia, hemoptysis, and hypoxemia. Diagnosis via CT angiography, V/Q scan, or D-dimer. Treated with anticoagulants (heparin, warfarin, DOACs), thrombolytics, IVC filters, and supportive care. 🫀 Pulmonary hypertension (PH) – idiopathic (IPAH) or secondary to other conditions; leads to right ventricular hypertrophy and failure. Managed with vasodilators, endothelin antagonists, PDE inhibitors, anticoagulants, diuretics, O₂, and in advanced cases, lung transplantation. 💔 Cor pulmonale – right-sided heart failure due to chronic pulmonary hypertension, requiring O₂, diuretics, vasodilators, and treatment of underlying lung disease. Environmental lung diseases include pneumoconiosis, asbestosis, silicosis, and hypersensitivity pneumonitis from occupational exposures. Prevention through protective equipment, regulation, and early detection is emphasized. The chapter concludes with oncology, focusing on lung cancer—the leading cause of cancer death. Risk factors include smoking, radon, asbestos, pollution, and genetic predisposition. Types include non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Clinical manifestations include persistent cough, hemoptysis, dyspnea, weight loss, and chest pain. Diagnosis involves chest imaging, bronchoscopy, biopsy, and TNM staging. Treatment includes surgery (lobectomy, pneumonectomy), radiation, chemotherapy, targeted therapy (EGFR, ALK, ROS1 inhibitors), immunotherapy (checkpoint inhibitors), and palliative care. Nursing care emphasizes smoking cessation, symptom management, psychosocial support, and education on treatment options. By integrating prevention, early recognition, interprofessional treatment, and patient-centered nursing care, this chapter equips nurses to manage the full spectrum of lower respiratory problems, from acute infections to chronic conditions and cancer. 📘 Read full blog summaries for every chapter: https://lastminutelecture.com 📘 Have a book recommendation? Submit your suggestion here: https://forms.gle/y7vQQ6WHoNgKeJmh8 Thank you for being a part of our little Last Minute Lecture family!